| NPI | 1770082042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW PARKER Owner/Clinician 307-887-9009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WY 355) |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2019-04-04 |